About this role
Role Overview
- Providing coordination of care to SNP members, including establishing and maintaining a care plan.
- Coordinating care with ICT members and coordinating care during transitions of care.
- Acting as a liaison for the Interdisciplinary Care Team (ICT) in conjunction with the PCP and beneficiary/caregiver.
- Collaborating with other CM team members to support the beneficiary through TOC events.
- Managing and triaging member self-referrals to care management programs.
- Assisting in ensuring compliance with CMS SNP Model of Care (MOC) expectations, NCQA standards, and Medicare Advantage regulatory requirements.
Requirements
- Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).
- Three (3) years of healthcare clinical experience.
- One (1) years Care Management, Case Management or Population Health experience.
- Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma.
- Management of Medicare and/or Medicaid and/ or SNP populations.
- One (1) year SNP Care Management experience.
Benefits
- Health insurance
- Competitive salary
- Paid time off